| Brent Frazee, Md, Llc | |
|
325 Nw 21st Ave Ste 100 Portland OR 97209-1179 | |
| (503) 886-8588 | |
| (503) 200-1011 |
| Full Name | Brent Frazee, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 325 Nw 21st Ave Ste 100, Portland, Oregon |
| Authorized Official Name and Position | Brent William Frazee (SOLE MEMBER) |
| Authorized Official Contact | 5126359382 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Frazee, Md, Llc 325 Nw 21st Ave Ste 100 Portland OR 97209-1179 Ph: (503) 886-8588 | Brent Frazee, Md, Llc 325 Nw 21st Ave Ste 100 Portland OR 97209-1179 Ph: (503) 886-8588 |
| NPI Number | 1861939282 |
|---|---|
| Provider Enumeration Date | 01/23/2017 |
| Last Update Date | 10/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861939282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD179772 (Oregon) | Primary |
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